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Hemolytic Uremic Syndrome in Children

What is hemolytic uremic syndrome (HUS) in children?

Hemolytic uremic syndrome (HUS) occurs when damaged red blood cells block the kidney's filtering system which can lead to kidney failure in children. The syndrome harms the small structures and vessels inside the kidneys. HUS causes red blood cells to clog the tiny blood vessels in the kidneys. It may cause damage to the kidney tissues. These problems make it harder for them to work and to remove waste and extra fluid from the blood. HUS is a serious illness and can be fatal. But most children with the most common form of HUS recover with full kidney function.

What causes hemolytic uremic syndrome in a child?

In children, HUS can develop after an infection with a toxic strain of E. coli bacteria. E. coli can be found in contaminated food, such as meats and dairy foods. Outbreaks have also occurred in fast food restaurants, because of undercooked hamburger meat. E. coli can also be found in contaminated water. HUS is more common during the summer and may occur in outbreaks. Outbreaks have been reported in daycare centers and water parks.

HUS can also develop from taking certain medicines, such as chemotherapy medicines. It may occur at the same time as cancer. Some rare cases of HUS run in families. This means it may sometimes be caused by a gene.

Which children are at risk for hemolytic uremic syndrome?

A child is more at risk for HUS if he or she:

Has been at a daycare center or water park where E. coli has been found

Has eaten food from a restaurant where people have gotten sick from E. coli

Has family members who have had HUS

Is taking certain medicines

Is under 5 years of age

Has a weakened immune system

What are the symptoms of hemolytic uremic syndrome in a child?

Symptoms can occur a bit differently in each child. The first symptoms of HUS often last from 1 to 15 days and may include:

Belly (abdominal) pain

Bloody or watery diarrhea

Vomiting

Fever

Severe problems in the bowel and colon may develop in some children, even after the above symptoms are gone. In these cases, a child may have symptoms such as:

Irritability

Tiredness

Small bruises in the lining of the mouth

Pale skin

Signs of extra water loss (dehydration)

If waste and extra fluid are not removed from the body, this can cause:

High blood pressure

Swollen parts of the body because of the extra fluid (edema)

Decreased urine output

The symptoms of HUS can seem like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.

How is hemolytic uremic syndrome diagnosed in a child?

The healthcare provider will ask about your child’s symptoms and health history. He or she will give your child a physical exam. Your child may also have tests, such as:

Stool test. This test looks for blood and checks for bacteria such as E. coli.

Kidney biopsy. A small piece of the kidney is removed and checked under a microscope.

How is hemolytic uremic syndrome treated in a child?

There is no treatment to stop HUS. But treatment can be done to help support your child during the illness. Your child may need close monitoring in an intensive care unit (ICU). Treatments in ICU may include:

IV (intravenous) fluids and electrolytes. This is done to treat dehydration.

Nutrition. Your child may need IV nutrition if he or she has severe digestive problems.

Dialysis. Dialysis may be needed in up to half of all children who develop HUS. Dialysis is a procedure to remove wastes and extra fluid from the blood when the kidneys have stopped working.

Medicine. Your child may need medicine to treat high blood pressure.

What are possible complications of hemolytic uremic syndrome in a child?

In some cases, HUS can cause death despite supportive treatment. But in most cases children recover from HUS without any long-lasting (permanent) damage to their health. In a few cases, the kidneys can be damaged and unable to work. The child must then continue to get dialysis. In these cases, the child may be considered for a kidney transplant.

How can I help prevent hemolytic uremic syndrome in my child?

You can help prevent E. coli infection in your family with these steps: